Form EIA-457A (Generic) EIA-457A (Generic) Residential Energy Consumption Survey: Cities Pilot

EIA-882T: Generic Clearance of Questionnaire Testing, Evaluating, and Research

RECS Pilot Tests Questionnaire for Generic Clearance_20150226

Residential Energy Consumption Survey (Cities Pilot)

OMB: 1905-0186

Document [docx]
Download: docx | pdf

RECS Web/Mail Pilot

Questionnaire Spec


STRUCTURAL CHARACTERISTICS


Please answer the following questions about the home at <sample address>.


TYPEHUQ

ASK

All respondents


Which best describes your home?


  1. Mobile home

  1. Single-family house detached from any other house

  2. Single-family house attached to one or more other houses (for example: duplex, row house, or townhome)

  3. Apartment in a building with 2 to 4 units

  4. Apartment in a building with 5 or more units


NEXT

If TYPEHUQ in(1,2,3): PRIMRES

If TYPEHUQ in(4,5): BASEAPT


BASEAPT

ASK

If TYPEHUQ in(4,5)


Is your apartment located in the basement of your building?


  1. Yes

  1. No


NEXT

PRIMRES



PRIMRES

ASK

All respondents


Is the home at <sample address> your primary residence? (Your primary residence is the place where you live most of the year.)


  1. Yes

  1. No


NEXT

OWNRENT





OWNRENT

ASK

All respondents


Is your home -


  1. Owned by you or someone in your household?

  2. Rented?

  3. Occupied without payment of rent?



NEXT

YEARMADERANGE


YEARMADERANGE

ASK

All respondents


In what year was your home built?


  1. Before 1950

  2. 1950 to 1959

  3. 1960 to 1969

  4. 1970 to 1979

  5. 1980 to 1989

  6. 1990 to 1999

  7. 2000 to 2009

  8. 2010 to 2015


Don’t Know


NEXT

OCCUPYYRANGE


OCCUPYYRANGE

ASK

All respondents


In what year did your household move in?


  1. Before 1950

  2. 1950 to 1959

  3. 1960 to 1969

  4. 1970 to 1979

  5. 1980 to 1989

  6. 1990 to 1999

  7. 2000 to 2009

  8. 2010 to 2015


NEXT

VACANT


VACANT

ASK

All respondents


During the past year, was your home vacant for one or more months?


  1. Yes

  1. No


Don’t Know


NEXT

If TYPEHUQ in(1,4,5): SQFTEST

If TYPEHUQ in(2,3): CELLAR


CELLAR

ASK

If TYPEHUQ in(2,3)


Does your home have a basement?


  1. Yes

  1. No


NEXT

If CELLAR=1: BASEFIN

If CELLAR=0: ATTIC


BASEFIN

ASK

If CELLAR=1


Is any part of your basement finished? For this survey, a “finished” basement has finishing materials on the floor, ceiling, and walls.


  1. Yes

  1. No


NEXT

ATTIC










ATTIC

ASK

If TYPEHUQ in(2,3)


Does your home have an attic?


  1. Yes

  1. No


NEXT

If ATTIC=1: ATTICFIN

If ATTIC=0: STORIES


ATTICFIN

ASK

If ATTIC=1


Is any part of your attic finished? That is, does it have finishing materials on the floor, ceiling, and walls?


  1. Yes

  1. No


NEXT

STORIES


STORIES

ASK

If TYPEHUQ in(2,3)


Not including basements or attics, how many stories does your home have?


  1. One story

  2. Two stories

  3. Three stories

  4. Four or more stories

  5. Split-level


NEXT

PRKGPLC1












PRKGPLC1

ASK

If TYPEHUQ in(2,3)


Does your home have an attached garage?


  1. Yes

  1. No


NEXT

If PRKGPLC1=1: SIZEOFGARAGE

If PRKGPLC1=0: SQFTEST


SIZEOFGARAGE

ASK

If TYPEHUQ in(2,3)


What is the size of your attached garage?


  1. One-car garage

  2. Two-car garage

  3. Three-or-more-car garage


NEXT

SQFTEST


SQFTEST

ASK

All respondents


About how many square feet is your home? Your best estimate will do.


_____ square feet


Don’t Know – consider having an experiment where half of the respondents receive this option, half do not


NEXT

If TYPEHUQ in(2,3): SQFTINCB, SQFTINCA, SQFTINCG, SQFTINCN, SQFTNONE

If TYPEHUQ in(1,4,5): BEDROOMS, NCOMBATH, NHAFBATH, OTHROOMS










SQFTINCB, SQFTINCA, SQFTINCG, SQFTINCN, SQFTNONE

ASK

If TYPEHUQ in(2,3)


Which of the following areas are included in your estimate of <square footage>? Please select all that apply.


Basement (SQFTINCB)

Attic (SQFTINCA)

Attached garage (SQFTINCG)

I have at least one of these spaces but none are included in my estimate (SQFTINCN)

My home does not have any of these spaces (SQFTNONE)


NEXT

BEDROOMS, NCOMBATH, NHAFBATH, OTHROOMS


BEDROOMS, NCOMBATH, NHAFBATH, OTHROOMS

ASK

All respondents


How many of the following types of rooms are in your home? If BASEFIN=1 or ATTICFIN=1:Include rooms in finished basements and finished attics.


____ Bedrooms (BEDROOMS)

____ Full bathrooms (A full bathroom includes a sink with running water, a toilet, and a bath or

shower.) (NCOMBATH)

____ Half bathrooms (A half bathroom includes a sink with running water and either a toilet, a bath, or

a shower.) (NHAFBATH)

____ Other rooms (Include living or family rooms, kitchens, home offices, etc. Do not include hallways,

closets, or rooms you already counted above.) (OTHROOMS)


NEXT

WALLTYPE

















WALLTYPE

ASK

All respondents


What type of material is the outside of your home made of? If more than one material is used, please select the one used the most.


  1. Brick

  2. Wood

  3. Siding (aluminum, vinyl, or steel)

  4. Stucco

  5. Shingle (composition)

  6. Stone

  7. Concrete or concrete block

  1. Other/specify


Don’t Know


NEXT

ROOFTYPE


ROOFTYPE

ASK

All respondents


What type of material is your home’s roof made of? If more than one material is used, please select the one used the most.


  1. Ceramic or clay tiles

  2. Wood shingles/shakes

  3. Metal

  4. Slate or synthetic slate

  5. Composition shingles

  6. Asphalt

  7. Concrete tiles

  1. Other/specify


Don’t Know


NEXT

CEILHEIGHT










CEILHEIGHT

ASK

All respondents


On average, how high are the ceilings in your home? Your best estimate will do.


_____ feet


Don’t Know


NEXT

DOOR1SUM


DOOR1SUM

ASK

All respondents


How many sliding glass doors does your home have? Count each pair of sliding glass doors as one door.


_____ sliding glass doors

Don’t Know


NEXT

WINDOWS


WINDOWS

ASK

All respondents


Approximately how many windows does your home have?

.”


  1. 1 or 2 windows

  1. 3 to 5 windows

  1. 6 to 9 windows

  1. 10 to 15 windows

  2. 16 to 19 windows

  1. 20 to 29 windows

  1. 30 or more windows


Don’t Know


NEXT

TYPEGLASS





TYPEGLASS

ASK

All respondents


Not counting storm windows, which best describes the glass in most of the windows in your home?


  1. Single-pane glass

  2. Double-pane glass

  3. Triple-pane glass


Don’t Know


NEXT

WINFRAME


WINFRAME

ASK

All respondents


What frame material is used for most of the windows in your home?


  1. Wood

  2. Metal (aluminum)

  3. Vinyl

  4. Composite

  5. Fiberglass

  1. Other/specify


Don’t Know


NEXT

ADQINSUL


ADQINSUL

ASK

All respondents


Which of these best describes the insulation level of your home?


  1. Well insulated

  2. Adequately insulated

  3. Poorly insulated

  4. Not insulated


NEXT

DRAFTY



DRAFTY

ASK

All respondents


How often do you or other members of your household find your home too drafty?


  1. All the time

  2. Most of the time

  3. Some of the time

  4. Never


NEXT

UGASHERE


UGASHERE

ASK

All respondents


Is natural gas from underground pipes available in your neighborhood?


  1. Yes

  1. No


Don’t Know


NEXT

NUMFRIG


APPLIANCES


NUMFRIG

ASK

All respondents


How many refrigerators are plugged-in and turned on in your home? Include refrigerators even if they are only used occasionally.


_____ refrigerators


NEXT

If NUMFRIG>0: SIZEFR1

Else: NUMFREEZ








SIZEFRI1

ASK

If NUMFRIG>0


What is the size of your most used refrigerator?


  1. Half-size or compact

  2. Small (17.5 cubic feet or less)

  3. Medium (17.6 to 22.5 cubic feet)

  4. Large (22.6 to 29.5 cubic feet)

  5. Very Large (bigger than 29.5 cubic ft.)


NEXT

If SIZEFRI1=1: AGEFRI1

Else: TYPERFR1

PAPER



TYPERFR1

ASK

If SIZEFRI1>1


Which of the following best describes your most used refrigerator?


  1. One door

  1. Two doors, freezer next to the refrigerator

  2. Two doors, freezer above the refrigerator

  3. Two doors, freezer below the refrigerator

  1. Three or more doors


NEXT

AGERFRI1


AGERFRI1

ASK

If NUMFRIG>0


About how old is your most used refrigerator? Your best estimate is fine.


  1. Less than 2 years old

  2. 2 to 4 years old

  3. 5 to 9 years old

  1. 10 to 14 years old

  2. 15 to 19 years old

  1. 20 or more years old

Don't know


NEXT

ICE


ICE

ASK

If NUMFRIG>0


Does your most used refrigerator have through-the-door ice service?


  1. Yes

0 No


NEXT

If NUMFRIG>1: SIZEFRI2

Else: NUMFREEZ


SIZEFRI2

ASK

If NUMFRIG>1


What is the size of your second most used refrigerator?


  1. Half-size or compact

  2. Small (17.5 cubic feet or less)

  3. Medium (17.6 to 22.5 cubic feet)

  4. Large (22.6 to 29.5 cubic feet)

  5. Very Large (bigger than 29.5 cubic ft.)


NEXT

If SIZEFRI2=1: AGERFRI2

Else: TYPERFR2


TYPERFR2

ASK

If SIZEFRI2>1


Which of the following best describes your second most used refrigerator?


  1. One door

  1. Two doors, freezer next to the refrigerator

  2. Two doors, freezer above the refrigerator

  3. Two doors, freezer below the refrigerator

  1. Three or more doors


NEXT

AGERFRI2







AGERFRI2

ASK

If NUMFRIG>1


About how old is your second most used refrigerator? Your best estimate is fine.


  1. Less than 2 years old

  2. 2 to 4 years old

  3. 5 to 9 years old

  1. 10 to 14 years old

  2. 15 to 19 years old

  1. 20 or more years old

Don't know


NEXT

FRIGLOC


FRIGLOC

ASK

If NUMFRIG>1


Where is your second refrigerator located?


Basement

Garage

Outside

Main floor of house

Other/Specify________


NEXT

NUMFREEZ

PAPER



NUMFREEZ

ASK

All respondents


How many stand alone freezers are plugged-in and turned on in your home?


_____ freezers


NEXT

If NUMFREEZ>0: UPRTFRZR

Else: NUMMEAL




UPRTFRZR

ASK

If NUMFREEZ>0

Which of the following best describes your most used freezer?


  1. Upright

  2. Chest


NEXT

SIZFREEZ


SIZFREEZ

ASK

If NUMFREEZ>0


What is the size of your most used freezer?


  1. Small (17.5 cubic feet or less)

  2. Medium (17.6 to 22.5 cubic feet)

  3. Large (22.6 to 29.5 cubic feet)

  4. Very Large (bigger than 29.5 cubic ft.)


NEXT

AGEFRZR


AGEFRZR

ASK

If NUMFREEZ>0


About how old is your most used freezer? Your best estimate is fine.


  1. Less than 2 years old

  2. 2 to 4 years old

  3. 5 to 9 years old

  1. 10 to 14 years old

  2. 15 to 19 years old

  1. 20 or more years old

Don't know


NEXT

NUMMEAL







NUMMEAL

ASK

All respondents


Which of the categories shown best describes how often hot food is usually cooked in your home?


  1. Three or more times a day

  2. Two times a day

  3. Once a day

  4. A few times each week

  5. About once a week

  6. Less than once a week

  1. Never


NEXT

STOVEN


STOVEN, STOVE, OVEN, MICRO

ASK

All respondents


How many of each of the following appliances do you have in your home?


____ Stoves/ranges (A stove/range has both a cooktop and an oven.) (STOVEN)

____ Separate cooktops (STOVE)

____ Separate wall ovens (OVEN)

____ Microwave ovens (MICRO)

NEXT

If STOVEN>0: STOVENFUEL

Else if STOVE>0: STOVEFUEL

Else if OVEN>0: OVENFUEL

Else if MICRO>0: AMTMICRO

Else if : TOASTER, TOASTOVN, COFFEE, CROCKPOT, FOODPROC, RICECOOK, MIXER, BREAD, BLENDER

Else if : DISHWASH

PAPER















STOVENFUEL

ASK

If STOVEN>0


What fuel does your most used stove/range use?


  1. Electricity

  1. Natural gas from underground pipes

  2. Propane (bottled gas)

  1. Other/specify


NEXT

STOVENCTUSE



STOVENCTUSE

ASK

If STOVEN>0


In a typical week, how often is the cooktop part of your most used stove/range used? If not used, enter “0.”


________ times per week


NEXT

STOVENOVUSE



STOVENOVUSE

ASK

If STOVEN>0


In a typical week, how often is the oven part of your most used stove/range used? If not used, enter “0.”


________ times per week


NEXT

If STOVE>0: STOVEFUEL

Else if OVEN>0: OVENFUEL

Else if MICRO>0: AMTMICRO

Else: TOASTER, TOASTOVN, COFFEE, CROCKPOT, FOODPROC, RICECOOK, MIXER, BREAD, BLENDER


STOVEFUEL

ASK

If STOVE>0


What fuel does your most used cooktop use?


  1. Electricity

  1. Natural gas from underground pipes

  2. Propane (bottled gas)

  1. Other/specify


NEXT

STOVEUSE



STOVEUSE

ASK

If STOVE>0


In a typical week, how often is your most used cooktop used? If not used, enter “0.”


________ times per week


NEXT

If OVEN>0: OVENFUEL

Else if MICRO>0: AMTMICRO

Else: TOASTER, TOASTOVN, COFFEE, CROCKPOT, FOODPROC, RICECOOK, MIXER, BREAD, BLENDER


OVENFUEL

ASK

If OVEN>0


What fuel does your most used separate wall oven use?


  1. Electricity

  1. Natural gas from underground pipes

  2. Propane (bottled gas)

  1. Other/specify


NEXT

OVENUSE



PAPER















OVENUSE

ASK

If OVEN>0


In a typical week, how often is your most used oven used? If not used, enter “0.”


________ times per week


NEXT

If MICRO>0: AMTMICRO

Else: TOASTER, TOASTOVN, COFFEE, CROCKPOT, FOODPROC, RICECOOK, MIXER, BREAD, BLENDER


AMTMICRO

ASK

If MICRO>0


In a typical week, how often is your most used microwave used? If not used, enter “0.”


________ times per week


NEXT

TOASTER, TOASTOVN, COFFEE, CROCKPOT, FOODPROC, RICECOOK, MIXER, BREAD, BLENDER



TOASTER, TOASTOVN, COFFEE, CROCKPOT, FOODPROC, RICECOOK, MIXER, BREAD, BLENDER

ASK

All respondents


Which of the following small kitchen appliances are used at least once a week in your home? Please select all that apply.


Toaster (TOASTER)

Toaster Oven (TOASTOVN)

Coffee Maker (COFFEE)

Crock Pot or Slow Cooker (CROCKPOT)

Food Processor (FOODPROC)

Rice Cooker (RICECOOK)

Stand Mixer (MIXER)

Bread Maker (BREAD)

Blender or Juicer (BLENDER)

Waffle maker (WAFFLE)

No small kitchen appliances


NEXT

DISHWASH


DISHWASH

ASK

All respondents


Does your household have an automatic dishwasher?


  1. Yes

0 No


NEXT

If DISHWASH=1: DWASHUSE

Else: CWASHER


DWASHUSE

ASK

If DISHWASH=1


In a typical week, how often is your dishwasher used? If not used, enter “0.”


________ times per week


NEXT

AGEDW


AGEDW

ASK

If DISHWASH=1


About how old is your dishwasher? Your best estimate is fine.


  1. Less than 2 years old

  2. 2 to 4 years old

  3. 5 to 9 years old

  1. 10 to 14 years old

  2. 15 to 19 years old

  1. 20 or more years old

Don't know


NEXT

DWCYCLE









DWCYCLE

ASK

If DISHWASH=1


Which cycle do you use most of the time when running your dishwasher?


  1. Normal or default cycle without heated dry

  2. Normal or default cycle with heated dry

  3. Heavy or pots and pans cycle

  4. Light or delicate cycle

  5. Energy saver

  6. Dishwasher not used


Don’t know


NEXT

CWASHER


CWASHER

ASK

All respondents


Does your household have a clothes washer? Do not include community clothes washers that are located in the basement or laundry room of your apartment building.


  1. Yes

0 No


NEXT

If CWASHER=1: TOPFRONT

Else: DRYER


TOPFRONT

ASK

If CWASHER=1


Is your washing machine one that you load from the top or one that you load from the front?


  1. Top loading

  2. Front loading


NEXT

WASHLOAD







WASHLOAD

ASK

If CWASHER=1


In a typical week, how often is your clothes washer used? If not used, enter “0.”


________ times per week


NEXT

WASHTEMP


WASHTEMP

ASK

If CWASHER=1


What water temperature setting is usually used for the wash cycle of your clothes washer?


1 Hot

2 Warm

3 Cold


NEXT

RNSETEMP


RNSETEMP

ASK

If CWASHER=1


What water temperature setting is usually used for the rinse cycle of your clothes washer?

1 Hot

2 Warm

3 Cold


NEXT

AGECWASH














AGECWASH

ASK

If CWASHER = 1


About how old is your clothes washer? Your best estimate is fine.


  1. Less than 2 years old

  2. 2 to 4 years old

  3. 5 to 9 years old

  1. 10 to 14 years old

  2. 15 to 19 years old

  1. 20 or more years old

Don't know


NEXT

DRYER


DRYER

ASK

All Respondents


Does your household have a clothes dryer? Do not include community clothes washers that are located in the basement or laundry room of your apartment building.


  1. Yes

0 No


NEXT

If DRYER=1: DRYRFUEL

Else TVCOLOR


DRYRFUEL

ASK

If DRYER=1


What fuel does your clothes dryer use?


  1. Electricity

  1. Natural gas from underground pipes

  2. Propane (bottled gas)


Don’t Know


NEXT

DRYRUSE




DRYRUSE

ASK

If DRYER=1


In a typical week, how often is your clothes dryer used? If not used, enter “0.”


________ times per week


NEXT

AGECDRYER


AGECDRYER

ASK

IF DRYER = 1


About how old is your clothes dryer? Your best estimate is fine.


  1. Less than 2 years old

  2. 2 to 4 years old

  3. 5 to 9 years old

  1. 10 to 14 years old

  2. 15 to 19 years old

  1. 20 or more years old

Don't know


NEXT

TVCOLOR



ELECTRONICS


TVCOLOR

ASK

All respondents


How many televisions are used in your home?


________ Televisions


NEXT

If TVCOLOR>0 : TVSIZE1

Else: DESKTOP, LAPTOP, TABLET, PCPRINT, ELECDEV






TVSIZE1

ASK

If TVCOLOR>0


What is the size of your most used television?


  1. 27 inches or less

  2. 27 to 39 inches

  3. 40 to 59 inches

  4. 60 inches or more


NEXT

TVTYPE1


TVTYPE1

ASK

If TVCOLOR>0


What type of display does your most used television have?


  1. LCD

  2. Plasma

  3. LED

  4. Projection

  5. Standard Tube


Don’t Know


NEXT

TVONWD1


TVONWD1

ASK

If TVCOLOR>0


Thinking about your most used television’s use on weekdays, how many hours is it turned on each day? Include the time it is on even if no one is actually watching it.


________ hours per day


NEXT

TVONWE1







TVONWE1

ASK

If TVCOLOR>0


Thinking about your most used television’s use on weekends, how many hours is it turned on each day? Include the time it is on even if no one is actually watching it.


________ hours per day


NEXT

If TVCOLOR>1: TVSIZE2

If TVCOLOR=1: CABLESAT, COMBODVR, DVR, PLAYSTA, DVD, VCR, INTERBOX, TVAUDIOSYS, OTHERSTB


TVSIZE2

ASK

If TVCOLOR>1


What is the size of your second most used television?


  1. 27 inches or less

  2. 27 to 39 inches

  3. 40 to 59 inches

  4. 60 inches or more


NEXT

TVTYPE2



TVTYPE2

ASK

If TVCOLOR>1


What type of display does your second most used television have?


  1. LCD

  2. Plasma

  3. LED

  4. Projection

  5. Standard Tube


Don’t Know


NEXT

TVONWD2





TVONWD2

ASK

If TVCOLOR>1


Thinking about your second most used television’s use on weekdays, how many hours is it turned on each day? Include the time it is on even if no one is actually watching it.


________ hours per day


NEXT

TVONWE2


TVONWE2

ASK

If TVCOLOR>1


Thinking about your second most used television’s use on weekends, how many hours is it turned on each day? Include the time it is on even if no one is actually watching it.


________ hours per day


NEXT

CABLESAT, COMBODVR, DVR, PLAYSTA, DVD, VCR, INTERBOX, TVAUDIOSYS


CABLESAT, COMBODVR, DVR, PLAYSTA, DVD, VCR, INTERBOX, TVAUDIOSYS

ASK

If TVCOLOR>0


How many of each of the following are used in your home?


________ Cable or satellite box without DVR (CABLESAT)

________ Cable or satellite box with DVR (COMBODVR)

________ Separate DVR (for example, TIVO) (DVR)

________ Video game console (PLAYSTA)

________ DVD or Blu-ray Players (DVD)

________ VCR (VCR)

________ Internet streaming device (for example: Apple TV, Slingbox, or Roku) (INTERBOX)

________ Home audio system (TVAUDIOSYS)



NEXT

DESKTOP, LAPTOP, TABLET, PCPRINT, ELECDEV







DESKTOP, LAPTOP, TABLET, PCPRINT, ELECDEV

ASK

All Respondents


How many of each of the following are used in your home?


________ Desktop computer (DESKTOP)

________ Laptop computer (LAPTOP)

________ Tablet computer or e-reader (for example: iPad or Kindle) (TABLET)

________ Printer, scanner, fax machine, or copier (PCPRINT)

________ Internet connected or“smart” phones (SMARTPHN)

________ Other cellular phones (ELECDEV)


NEXT

INTERNET



INTERNET

ASK

All respondents


In your home, do you or any member of your household access the Internet?


  1. Yes, with a subscription to an Internet service

  2. Yes, without a subscription to an Internet service

0 No internet access in this home


NEXT

IF INTERNET = 1: INACCESS

Else: HEATHOME


INACCESS

ASK

IF INTERNET = 1


In your home, do you or any member of your household subscribe to the Internet using – Please select all that apply.


Dial-up service?

DSL service?

Cable modem service?

Fiber optic service?

Mobile broadband plan for a computer or a cell phone?

Satellite Internet service?

Other/specify


NEXT

INWIRELESS


INWIRELESS

ASK

IF INTERNET = 1


Do you have a wireless router for access to the Internet in your home?


  1. Yes

  1. No


Don’t know


NEXT

HEATHOME


SPACE HEATING


HEATHOME

ASK

All respondents


Is your home heated during the winter?


1 Yes

0 No


NEXT

If HEATHOME = 1: EQUIPM

Else: AIRCOND




EQUIPM

ASK

If HEATHOME=1


What is the main type of heating equipment used to provide heat for your home?


  1. Central furnace

  2. Heat pump

  3. Steam or hot water system with radiators or pipes

  4. Built-in electric units installed in walls, ceilings, baseboards, or floors

  5. Built-in floor/wall pipeless furnace

  6. Built-in room heater burning gas, oil, or kerosene

  7. Heating stove burning wood, coal, or coke

  8. Portable electric heaters

  9. Fireplace

  10. Other/Specify


Don't Know


NEXT

EQUIPAGE


EQUIPAGE

ASK

If HEATHOME=1


Approximately how old is your home's main heating equipment?


  1. Less than 2 years old

  2. 2 to 4 years old

  3. 5 to 9 years old

  1. 10 to 14 years old

  2. 15 to 19 years old

  1. 20 or more years old

Don't know


NEXT

FUELHEAT


FUELHEAT

ASK

If HEATHOME=1


What is the main fuel used by this equipment for heating your home?


  1. Electricity

  1. Natural gas from underground pipes

  2. Propane (bottled gas)

  3. Fuel oil

  1. Wood

  1. Other/Specify


Don't Know


NEXT

THERMAIN


THERMAIN

ASK

If HEATHOME=1


Does your household use a thermostat to control the main heating equipment?


  1. Yes

0 No


NEXT

IF THERMAIN = 1: PROTHERM

Else THERMUSE


PROTHERM

ASK

If THERMAIN=1


Is the thermostat that controls the main heating equipment in your home programmable?


  1. Yes

  1. No


Don’t Know


NEXT

THERMUSE


THERMUSE

ASK

If HEATHOME=1


Which of the following best describes how your household controls the main heating equipment most of the time in your home?


  1. Set one temperature on the thermostat and leave it there most of the time

  2. Manually adjust the temperature at night or when no one is at home

  3. Program the thermostat to automatically adjust the temperature at certain times

  4. Turn equipment on or off when needed

  5. Our household does not have control over the temperature

  6. Other/Specify


NEXT

TEMPHEATDAY


TEMPHEATDAY

ASK

If HEATHOME=1


What is the usual temperature setting in your home during most winter days?


  1. 62 degrees or less

  2. 63 to 66 degrees

  3. 67 to 70 degrees

  4. 71 to 74 degrees

  5. 75 degrees or more


Don’t know


NEXT

TEMPHEATNIGHT


TEMPHEATNIGHT

ASK

If HEATHOME=1


What is the usual temperature setting in your home during most winter nights?


  1. 62 degrees or less

  2. 63 to 66 degrees

  3. 67 to 70 degrees

  4. 71 to 74 degrees

  5. 75 degrees or more


Don’t know


NEXT

EQUIPAUX


EQUIPAUX

ASK

If HEATHOME=1


In addition to your main heating equipment, does your household also use any of the following as a second source for heating your home? (If more than one, select the type most frequently used.)


  1. No other equipment used

  2. Central furnace

  3. Heat Ppump

  4. Steam or hot water system with radiators or pipes

  5. Built-in electric units installed in walls, ceilings, baseboards, or floors

  6. Built-in floor/wall pipeless furnace

  7. Built-in room heater burning gas, oil, or kerosene

  8. Heating stove burning wood, coal, or coke

  9. Portable electric heaters

  10. Fireplace

  11. Other/Specify


Don't Know


NEXT

If EQUIPAUX=0: BASEHEAT, ATTICHEAT, GARAGEHEAT

If EQUIPAUX≠0: FUELHEATAUX










FUELHEATAUX

ASK

If EQUIPAUX≠0


What is the fuel used by this second type of equipment for heating your home?


  1. Electricity

  1. Natural gas from underground pipes

  2. Propane (bottled gas)

  3. Fuel oil

  1. Wood

  1. Other/Specify


Don't Know


NEXT

BASEHEAT, ATTICHEAT, GARAGEHEAT


BASEHEAT, ATTICHEAT, GARAGEHEAT

ASK

If HEATHOME=1


Which of the following spaces are heated? Please select all that apply.


  1. Basement (BASEHEAT)

  2. Attic (ATTICHEAT)

  3. Attached garage (GARAGEHEAT)

  4. I have at least one of these spaces but none are heated (HEATINCN)

  5. My home does not have any of these spaces (HEATNONE)


NEXT

MOISTURE


MOISTURE

ASK

All Respondents


Humidifiers add moisture to the air and are often used in the winter. Is a humidifier used in your home?


  1. Yes

0 No


NEXT

If MOISTURE=1: USEMOISTURE

Else: AIRCOND





USEMOISTURE

ASK

If MOISTURE=1


How many months is your humidifier used?


  1. 1 to 3 months

  2. 4 to 6 months

  3. 7 to 9 months

  4. 10 to 11 months

  5. Turned on all year


NEXT

AIRCOND


AIR CONDITIONING


AIRCOND

ASK

All respondents


Was any air conditioning equipment used in your home last summer?


  1. Yes

0 No


NEXT

If AIRCOND=1: CENTRALAC, WWAC, PORTAC, SWAMPCOL

Else: NUMCFAN, NUMFLOORFAN, NUMATTICFAN


CENTRALAC, WWAC, PORTAC, SWAMPCOL

ASK

If AIRCOND=1


What type of air conditioning equipment was used in your home last summer? Please select all that apply.


Central air conditioning system (CENTRALAC)

Individual units in the windows or wall (WWAC)

Portable air conditioners (PORTAC)

Evaporative or swamp cooler (SWAMPCOL)


NEXT

If CENTRALAC=1: CENACHP

Else if WWAC=1: NUMBERAC

Else: NUMCFAN, NUMFLOORFAN, NUMATTICFAN




CENACHP

ASK

If CENTRALAC=1


Is your central air conditioning system a heat pump?


  1. Yes

  1. No


Don’t know


NEXT

AGECENAC



AGECENAC

ASK

If CENTRALAC=1


How old is your central air conditioning system?


  1. Less than 2 years old

  2. 2 to 4 years old

  3. 5 to 9 years old

  1. 10 to 14 years old

  2. 15 to 19 years old

  1. 20 or more years old

Don't know


NEXT

THERMAINAC


THERMAINAC

ASK

If CENTRALAC=1


Does your household use a thermostat to control the central air conditioning system?


  1. Yes

0 No


NEXT

PROTHERMAC





PROTHERMAC

ASK

If THERMAIN=1


Is the thermostat that controls the central air conditioning system in your home programmable?


  1. Yes

  1. No


Don’t Know


NEXT

THERMUSEAC


THERMUSEAC

ASK

If CENTRALAC=1


Which of the following best describes how your household controlled the central air conditioning system last summer?


  1. Set one temperature on the thermostat and leave it there most of the time

  2. Manually adjust the temperature at night or when no one is at home

  3. Program the thermostat to automatically adjust the temperature at certain times

  4. Turn equipment on or off when needed

  5. Our household does not have control over the temperature

  6. Other/Specify


NEXT

TEMPACDAY


TEMPACDAY

ASK

If CENTRALAC=1


What was the usual temperature setting in your home during most days last summer?


  1. 62 degrees or less

  2. 63 to 66 degrees

  3. 67 to 70 degrees

  4. 71 to 74 degrees

  5. 75 degrees or more


Don’t know


NEXT

TEMPACNIGHT


TEMPACNIGHT

ASK

If CENTRALAC=1


What was the usual temperature setting in your home during most nights last summer?


  1. 62 degrees or less

  2. 63 to 66 degrees

  3. 67 to 70 degrees

  4. 71 to 74 degrees

  5. 75 degrees or more


Don’t know


NEXT

If WWAC=1: NUMBERAC

If WWAC=0: BASECOOL, ATTICCOOL, GARAGECOOL


NUMBERAC

ASK

If WWAC=1


How many window or wall air conditioning units were used in your home last summer?


______ units


NEXT

WWACAGE


WWACAGE

ASK

If WWAC=1


How old is the most used window or wall unit?


  1. Less than 2 years old

  2. 2 to 4 years old

  3. 5 to 9 years old

  1. 10 to 14 years old

42 15 to 19 years old

  1. 20 or more years old

Don't know


NEXT

USEWWAC




USEWWAC

ASK

If and WWAC=1


Which of the following best describes how your household used the most used window or wall unit last summer?


  1. Used only a few days or nights when really needed

  2. Used some days or nights

  3. Used most or all days and nights

  1. Other/specify


NEXT

BASECOOL, ATTICCOOL, GARAGECOOL


BASECOOL, ATTICCOOL, GARAGECOOL

ASK

If AIRCOND=1


Which of the following spaces are air conditioned? Please select all that apply.


Basement (BASECOOL)

Attic (ATTICCOOL)

Attached garage (GARAGECOOL)

I have at least one of these spaces but none are air conditioned (COOLINCN)

My home does not have any of these spaces (COOLNONE)


NEXT

NUMCFAN, NUMFLOORFAN, NUMATTICFAN


NUMCFAN, NUMFLOORFAN, NUMATTICFAN

ASK

All respondents


How many of the following types of fans does your household use?


_____ Ceiling fans (NUMCFAN)

_____ Floor or window fans (NUMFLOORFAN)

_____ Whole house (NUMWHOLEFAN)

_____ Attic fans (NUMATTICFAN)



NEXT

NOTMOIST





NOTMOIST

ASK

All Respondents


Dehumidifiers remove moisture from the air and are often used in the summer. Is a dehumidifier used in your home?


  1. Yes

0 No


NEXT

If NOTMOIST=1: USENOTMOIST

Else:H2OMAIN


USENOTMOIST

ASK

IF NOTMOIST=1


How many months is your dehumidifier used?


  1. 1 to 3 months

  2. 4 to 6 months

  3. 7 to 9 months

  4. 10 to 11 months

  5. Turned on all year


NEXT

H2OMAIN


WATER HEATING


H2OMAIN

ASK

All respondents


What is the main water heating equipment used in your home?


  1. Storage water heating tank(s) in home

  2. Tankless or on-demand water heater(s) in home

  3. Water heater is outside my home or unit, such as in an apartment building

  1. Other/Specify


NEXT

If H2OMAIN=1: WHEATSIZ

Else: WHEATAGE





WHEATSIZ

ASK

If H2OMAIN=1


What is the size of the water heating storage tank in your home? (If more than one, answer for the largest.)


  1. Small (30 gallons or less)

  2. Medium (31 to 49 gallons)

  3. Large (50 gallons or more)


Don’t know


NEXT

WHEATAGE


WHEATAGE

ASK

All respondents


How old is your main water heating equipment?


  1. Less than 2 years old

  2. 2 to 4 years old

  3. 5 to 9 years old

  1. 10 to 14 years old

42 15 to 19 years old

  1. 20 or more years old

Don't know


NEXT

FUELH2O


FUELH2O

ASK

All respondents


What fuel does your main water heating equipment use?


  1. Electricity

  1. Natural gas from underground pipes

  2. Propane (bottled gas)

  3. Fuel oil

  1. Wood

  1. Other/Specify


Don't Know


NEXT

LGTINNUM



LIGHTING


LGTINNUM

ASK

All respondents


Approximately how many light bulbs are installed inside your home? Include light bulbs in ceiling fixtures and fans, table and floor lamps, as well as those used infrequently, such as in hallways, closets, and garages. For fixtures with multiple bulbs, count each bulb separately.


  1. Less than 20 light bulbs

  2. 20 to 39 light bulbs

  3. 40 to 59 light bulbs

  4. 60 to 79 light bulbs

  5. 80 or more light bulbs


Don’t Know


NEXT

LGTIN4

PAPER



LGTIN4

ASK

All respondents


How many of the light bulbs inside your home are used at least 4 hours per day?


______ light bulbs


NEXT

LGTINCAN



LGTINCAN

ASK

All respondents


How many of the light bulbs installed inside your home are incandescent bulbs?


  1. All

  2. Most

  3. About half

  4. Some

  1. None


Don’t Know


NEXT

LGTINCFL




LGTINCFL

ASK

All respondents


How many of the light bulbs installed inside your home are CFL bulbs?


  1. All

  2. Most

  3. About half

  4. Some

  1. None


Don’t Know


NEXT

LGTINLED


LGTINLED

ASK

All respondents


How many of the light bulbs installed inside your home are LED bulbs?


  1. All

  2. Most

  3. About half

  4. Some

  1. None


Don’t Know


NEXT

LGTINDIM



LGTINDIM

ASK

All respondents


Are any of the light bulbs inside your home controlled by dimmers or timers?


  1. Yes

  1. No



NEXT

LGTOUTNUM


LGTOUTNUM

ASK

All respondents


Approximately how many light bulbs are installed outside your home? For apartments, only include lights connected to your unit.


  1. None

  2. 1 to 4 bulbs

  3. 5 to 9 bulbs

  4. 10 or more bulbs


Don’t Know


NEXT

If LGTOUTNUM>0: LGTOUTCAN, LGTOUTCFL, LGTOUTLED, LGTOUTNG

Else: SWIMPOOL


LGTOUTCAN, LGTOUTCFL, LGTOUTLED, LGTOUTNG, LGTOUTSOL

ASK

If LGTOUTNUM>0


Which of the following types of lights are used outside your home? Please select all that apply.


Incandescent bulbs (LGTOUTCAN)

CFL bulbs (LGTOUTCFL)

LED bulbs (LGTOUTLED)

Natural gas lights (LGTOUTNG)

NEXT

LGTOUTMOD


LGTOUTMOD

ASK

If LGTOUTNUM>0


Are any of the light bulbs outside your home controlled by motion detectors or light sensors?


  1. Yes

  1. No


NEXT

SWIMPOOL








MISCELLANEOUS


SWIMPOOL

ASK

All respondents


Does your home have its own swimming pool?


  1. Yes

  1. No


NEXT

If SWIMPOOL=1: FUELPOOL

Else: RECBATH


FUELPOOL

ASK

If SWIMPOOL=1


What fuel is used to heat the water in your swimming pool?


  1. None, my swimming pool is not heated

  1. Electricity

  1. Natural gas from underground pipes

  2. Propane (bottled gas)

  3. Fuel oil

  1. Solar

  2. Other/specify


Don’t Know


NEXT

RECBATH


RECBATH

ASK

All respondents


Does your home have its own heated hot tub, spa, or Jacuzzi, other than a bathtub?


  1. Yes

  1. No


NEXT

If RECBATH=1: FUELTUB

Else: AUDIT




FUELTUB

ASK

If RECBATH=1


What fuel is used to heat the water in your heated hot tub, spa, or Jacuzzi?


  1. Electricity

  1. Natural gas from underground pipes

  2. Propane (bottled gas)

  3. Fuel oil

  1. Solar

  2. Other/specify


Don’t Know


NEXT

AUDIT


AUDIT

ASK

All respondents


A home energy audit is when a trained professional examines how energy is used in all parts of a home. After examining a home, the energy auditor will provide a list of ways to reduce energy use and save money on energy bills. Has your home had an energy audit?


  1. Yes

  1. No


Don’t Know


NEXT

If AUDIT=1: AUDITCHG

Else: EEPRODUCT, FREEAUDIT, MRREBATE, SUPPREBATE, RECYCAPP, SUBLOAN, TAXCREDIT, WEATHERIZATION, LIHEAP, BENOTHER


AUDITCHG

ASK

If AUDIT=1


Did your household make any of the changes suggested by the energy auditor?


  1. Yes

  1. No


NEXT

If AUDITCHG=1: AUDITCHGOPEN

Else: EEPRODUCT, FREEAUDIT, MRREBATE, SUPPREBATE, RECYCAPP, SUBLOAN, TAXCREDIT, WEATHERIZATION, LIHEAP, BENOTHER


AUDITCHGOPEN

ASK

If AUDITCHG=1


Please describe the changes your household made.


____________________________________________


NEXT

EEPRODUCT, FREEAUDIT, MRREBATE, SUPPREBATE, RECYCAPP, SUBLOAN, TAXCREDIT, WEATHERIZATION, LIHEAP, BENOTHER



EELIGHTS, EETHERM, FREEAUDIT, REBATEAPP, RECYCAPP, SUBLOAN, TAXCREDITAPP, TAXCREDITWIN, WEATHERIZATION, LIHEAP, BENOTHER

ASK

All respondents


Has your household received any of the following energy-related benefits or assistance at this home? Please select all that apply.


Free or subsidized energy-efficient light bulbs (EELIGHTS)

Free or subsidized programmable thermostat (EETHERM)

Free or subsidized home energy audit (FREEAUDIT)


Utility or energy supplier rebate for new appliance or equipment (REBATEAPP)

Recycling of old appliance or equipment (for example, a refrigerator) (RECYCAPP)

Subsidized loan for new appliance or equipment (SUBLOAN)

Tax credit for new appliance or equipment (TAXCREDITAPP)

Tax credit for new windows or insulation (TAXCREDITWIN)


Weatherization assistance program (WEATHERIZATION)

Low income home energy assistance (for example, LIHEA) (LIHEAP)


Other/specify (BENOTHER)


My household has not received any of these benefits or assistance


NEXT

ESCWASH, ESDRYER, ESDISHW, ESFREEZ, ESLIGHT, ESFRIG, ESWATER, ESWIN











ESCWASH, ESDRYER, ESDISHW, ESFREEZ, ESLIGHT, ESFRIG, ESWATER, ESWIN

ASK

All respondents


Which of the following products in your home are ENERGY STAR qualified? Please select all that apply.


Clothes Washer

Clothes Dryer

Dishwasher

Refrigerator

Freezer

Light Bulbs

Water Heater

Windows

None



NEXT

SMARTTHERM



SMARTTHERM

ASK

All respondents


Does your home have a “smart” or Internet-connected thermostat?


  1. Yes

  1. No


Don’t Know


NEXT

SMARTMETER


SMARTMETER

ASK

All respondents


Does your home have a “smart meter,” which records electricity usage in short time intervals and automatically transmits it to your utility company?


  1. Yes

  1. No


Don’t Know


NEXT

If SMARTMETER=1: INTDATA

Else: OUTLET


INTDATA

ASK

If SMARTMETER=1


Does your household have access to hourly or daily electricity usage information recorded by your smart meter?

  1. Yes

  1. No


Don’t Know


NEXT

If INTDATA=1: INTDATAACC

Else: OUTLET


INTDATAACC

ASK

If INTDATA=1


Have you ever accessed or viewed this interval data?


  1. Yes

  1. No


NEXT

OUTLET


OUTLET

ASK

All respondents


Do you or any member of your household park a vehicle within about 20 feet of an electric outlet?


  1. Yes

  1. No


NEXT

ELECVEH

PAPER










ELECVEH

ASK

All respondents


Do you or any member of your household own or lease a plug-in electric vehicle?


  1. Yes

  1. No


NEXT

OTHFUELUSE


FUELS AND SUPPLIERS


OTHFUELUSE

ASK

All respondents


Are there any other fuels used in your home that you have not already answered about? If so, please list the fuel(s) and how it is used.


Open-ended response


__-Don’t use any other fuel



NEXT

OTHACT


OTHACT

ASK

All respondents


Are there any activities occurring in your home that use a lot more energy than would usually be used in a home?


Open-ended response


___No high energy-using activities



NEXT

BACKUP






BACKUP

ASK

All respondents


Does your household have a back-up generator that can be used for generating electricity in case of a power outage or emergency?


  1. Yes

  1. No


NEXT

ONSITETYPE


ONSITETYPE

ASK

All respondents


Not including back-up generators, does your home have any of these on-site systems that generates electricity?


  1. No on-site generation system

  2. Solar or photovoltaic system

  3. Small wind turbine

  4. Combined heat and power system

  1. Other/specify


NEXT

ELPAY


ELPAY

ASK

All respondents


Which of the following describes who is responsible for paying for the electricity used in this home?


  1. Household is responsible for paying for all electricity used in this home

  2. All electricity used in this home is included in the rent or condo fee

  3. Some is paid by the household, some is included in the rent or condo fee

  1. Other/specify


Don’t Know


NEXT

If STOVENFUEL=1 or STOVEFUEL=1 or OVENFUEL=1 or DRYRFUEL=1 or FUELHEAT=1 or

FUELHEATAUX=1 or FUELH2O=1 or FUELPOOL=1 or FUELTUB=1: NGPAY

Else if STOVENFUEL=2 or STOVEFUEL=2 or OVENFUEL=2 or DRYRFUEL=2 or

FUELHEAT=2 or FUELHEATAUX=2 or FUELH2O=2 or FUELPOOL=2 or FUELTUB=2:

LPGPAY

Else if FUELHEAT=3 or FUELHEATAUX=3 or FUELH2O=3 or FUELPOOL=3 or FUELTUB=3:

FOPAY

Else KFUELOT




NGPAY

ASK

If STOVENFUEL=1 or STOVEFUEL=1 or OVENFUEL=1 or DRYRFUEL=1 or FUELHEAT=1 or FUELHEATAUX=1 or FUELH2O=1 or FUELPOOL=1 or FUELTUB=1


Which of the following describes who is responsible for paying for the natural gas used in this home?


  1. Household is responsible for paying for all natural gas used in this home

  2. All natural gas used in this home is included in the rent or condo fee

  3. Some is paid by the household, some is included in the rent or condo fee

  1. Other/specify


Don’t Know


NEXT

If STOVENFUEL=2 or STOVEFUEL=2 or OVENFUEL=2 or DRYRFUEL=2 or FUELHEAT=2 or

FUELHEATAUX=2 or FUELH2O=2 or FUELPOOL=2 or FUELTUB=2: LPGPAY

Else if FUELHEAT=3 or FUELHEATAUX=3 or FUELH2O=3 or FUELPOOL=3 or FUELTUB=3:

FOPAY

Else KFUELOT


LPGPAY

ASK

If STOVENFUEL=2 or STOVEFUEL=2 or OVENFUEL=2 or DRYRFUEL=2 or FUELHEAT=2 or FUELHEATAUX=2 or FUELH2O=2 or FUELPOOL=2 or FUELTUB=2


Which of the following describes who is responsible for paying for the propane used in this home?


  1. Household is responsible for paying for all propane used in this home

  2. All propane used in this home is included in the rent or condo fee

  3. Some is paid by the household, some is included in the rent or condo fee

  1. Other/specify


Don’t Know


NEXT

If FUELHEAT=3 or FUELHEATAUX=3 or FUELH2O=3 or FUELPOOL=3 or FUELTUB=3:

FOPAY

Else: KFUELOT












FOPAY

ASK

If FUELHEAT=3 or FUELHEATAUX=3 or FUELH2O=3 or FUELPOOL=3 or FUELTUB=3


Which of the following describes who is responsible for paying for the fuel oil used in this home?


  1. Household is responsible for paying for all fuel oil used in this home

  2. All fuel oil used in this home is included in the rent or condo fee

  3. Some is paid by the household, some is included in the rent or condo fee

  1. Other/specify


Don’t Know


NEXT

KFUELOT


KFUELOT

ASK

All respondents


Do any of your household energy bills include costs for energy used for non-household purposes, such as farm buildings or machinery, a business or office, or another house or apartment?


  1. Yes

  1. No


NEXT

If KFUELOT=1: BILLEL, BILLUG, BILLLPG, BILLFOIL, BILLKER

Else: ELSUPPNAME, ELACCT, NGSUPPNAME, NGACCT, LPSUPPNAME, LPACCT, FKSUPPNAME, FKACCT, AUTHORIZATION


BILLEL, BILLUG, BILLLPG, BILLFK

ASK

If KFUELOT=1


Which of your household’s energy bills include costs for energy used for non-household purposes? Please select all that apply.


Electricity (BILLEL)

Natural gas from underground pipes (BILLUG)

Propane (bottled gas) (BILLLPG)

Fuel oil or kerosene (BILLFK)


NEXT

ELSUPPNAME, ELACCT, NGSUPPNAME, NGACCT, LPSUPPNAME, LPACCT, FKSUPPNAME, FKACCT, AUTHORIZATION



ELSUPPNAME, ELACCT, NGSUPPNAME, NGACCT, LPSUPPNAME, LPACCT, FKSUPPNAME, FKACCT, AUTHORIZATION

ASK

All respondents

In addition to the answers you’ve provided in this survey, we would like to find out how much energy your household actually used in the past year.


Please provide the names of your energy supplier(s) and the account number for each fuel used by your household?


Electricity __________________________ (ELSUPPNAME) ________________ (ELACCT)

Natural Gas __________________________ (NGSUPPNAME) ________________ (NGACCT

Propane __________________________ (LPSUPPNAME) _______________ (LPACCT)

Fuel Oil or Kerosene __________________________ (FKSUPPNAME) ________________ (FKACCT)


Shape1 I hereby give permission to this company or companies to provide information about the energy consumption at <sample address> to the U.S. Energy Information Administration for confidential use in connection with the Residential Energy Consumption Survey. (AUTHORIZATION)


_____ Initials


NEXT

HHSEX


HOUSEHOLD CHARACTERISTICS


HHSEX

ASK

All respondents


What is your sex?


  1. Female

  2. Male


NEXT

HHAGE


HHAGE

ASK

All respondents


What is your age?


_____ years old


NEXT

If : EMPLOYHH

If : SDESCENT


EMPLOYHH

ASK

All respondents


Which best describes your employment status?


  1. Employed full-time

  2. Employed part-time

  3. Not employed/retired


NEXT

EDUCATION


EDUCATION

ASK

All respondents


What is the highest degree or level of school you have completed?


  1. Less than high school diploma or GED

  2. High school diploma or GED

  3. Some college or Associate’s degree

  4. Bachelor’s degree (for example: BA, BS)

  5. Master’s, Professional, or Doctorate degree (for example: MA, MS, MBA, MD, JD, PhD)


NEXT

SDESCENT


SDESCENT

ASK

All respondents


Are you Hispanic or Latino?


  1. Yes

  1. No


NEXT

RACE_WHITE, RACE_BLACK, RACE_AIAN, RACE_ASIAN, RACE_NHPI, RACE_OTH










RACE_WHITE, RACE_BLACK, RACE_AIAN, RACE_ASIAN, RACE_NHPI, RACE_OTH

ASK

All respondents


What is your race? Please select all that apply.


White (RACE_WHITE)

Black or African-American (RACE_BLACK)

American Indian or Alaska Native (RACE_AIAN)

Asian (RACE_ASIAN)

Native Hawaiian or Other Pacific Islander (RACE_NHPI)

Other/specify (RACE_OTH)


NEXT

NHSLDMEM


NHSHLDMEM

ASK

All respondents


Including yourself, how many people usually live in this home? Do not include anyone who is just visiting, those away in the military, or children who are away at college.


_____ household members


NEXT

NUMADULT


NUMADULT

ASK

All respondents


How many members of your household are adults (18 years of age or older)?


_____ adults


NEXT

NUMCHILD


NUMCHILD

ASK

All respondents


How many members of your household are children (17 years of age or younger)?


_____ children


NEXT

ATHOMEDAYS


ATHOMEDAYS

ASK

All respondents


In a typical week, how many weekdays is someone at home most or all of the day?


  1. None

  2. 1 day

  3. 2 days

  4. 3 days

  5. 4 days

  6. 5 days


NEXT

MONEYPY


MONEYPY

ASK

All respondents


Including all income sources, which category best describes the 2014 total combined income of all members of your household before taxes and deductions? 


  1. Less than $20,000

  2. $20,000 - $39,999

  3. $40,000 - $59,999

  4. $60,000 to $79,999

  5. $80,000 to $99,999

  6. $100,000 to $119,999

  7. $120,000 to $139,999

  8. $140,000 or more


NEXT

End Survey


WHYPAPER

ASK

All respondents receiving nonresponse follow-up paper version of questionnaire


Which of the following best describes why you chose to respond to this survey by mail.


  1. No Web access

  2. I prefer to respond to surveys by mail

  3. I had problems responding by Web

  4. I did not know there was an option to respond by Web

  5. Other/Specify


NEXT

End Survey


50


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title2003 CBECS Pre-Test Questionnaire
AuthorJoelle D. Michaels
File Modified0000-00-00
File Created2021-01-25

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